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True Cause of Bloat Goes Under the Microscope

It won’t be this year, and most likely not next, but sometime in the next few years, we may actually find out – once and for all – what causes gastric dilatation-volvulus, more commonly known as bloat, and what triggers its occurrence.

The American Kennel Club Canine Health Foundation offers this description of GDV: “Gastric dilatation-volvulus, or bloat, is a devastating condition that can develop in any dog, although it is particularly common in large-breed and deep-chested dogs. Bloat develops when the stomach fills with air and then twists on itself, preventing air and liquid from leaving the stomach. Over time, the stomach gets larger and larger. This cuts off circulation and prevents blood from getting back to the heart from the rest of the abdomen and the rear legs. The stomach wall itself can also be severely damaged from loss of blood flow as can the spleen. Bloat requires immediate stabilization and prompt surgical correction, and may still be fatal in some severely affected dogs.”

To dig into the actual cause of GDV, the Canine Health Foundation has secured $250,000 for the first of up to three similar funding cycles for research grants, as part of its Bloat Initiative, as well as more than $50,000 toward the second round of funding.

The number of dogs diagnosed with GDV each year in the United States is “really unknown,” according to Elizabeth Rozanski, D.V.M., an associate professor of emergency and critical care at the Tufts University Cummings School of Veterinary Medicine in North Grafton, Mass. “The best estimates would be in the 50,000 range,” she says. Fewer than 5 percent survive without surgery, she says, and those are dogs whose stomachs return to their “normal position spontaneously. This is very uncommon,” she adds.

Of the last 500 dogs treated at Tufts, Rozanski says about 80 percent had surgery to untwist the stomach, then tack it to the abdominal wall to help prevent future occurrences. Of those having surgery, about 15 percent don’t survive because of “completely necrotic stomachs” or post-operative “multiple organ failure.”

If national statistics echo those at Tufts, and based on Rozanki’s estimate of nationwide GDV occurrence, about 7,500 dogs die each year – and those are just the ones diagnosed and treated. Some owners simply find a dog dead in its kennel or elsewhere if the dog’s reaction to GDV goes unnoticed during the night, for example. And some dogs are euthanized at veterinary clinics upon diagnosis “for sure,” she says.

Shila Nordone, Ph.D., chief scientific officer for CHF since January 2012, says there have been “several very strong epidemiological” research efforts, and “people have looked at feeding practices and several different things.” Indeed, a survey of 2,500 dogs, whose results were published in the June, 15, 2012, issue of the Journal of the American Veterinary Medical Association, concluded: “In dogs with a high risk of GDV, regular moderate daily and postprandial [after a meal] activity appeared to be beneficial. Feeding only commercial dry dog food may not be the best choice for dogs at risk; however, supplements with fish or eggs may reduce this risk. The effect of neuter status on GDV risk requires further characterization.” No definites there.

“At the end of these, there are only associations,” Nordone says. In other words, walking after meals is associated with GDV prevention, but it’s not guaranteed. Adding fish or eggs to commercial food “may” help. As to whether neutering has any effect: Who knows? We’ve heard that dogs shouldn’t eat out of raised dishes, we shouldn’t add water to kibble and myriad other things that might increase the risk of bloat.

Some of the breeds considered at high risk for GDV are German Shepherd Dogs, Great Danes, Collies, Gordon Setters, Irish Setters, Bloodhounds, Akitas, Saint Bernards, Mastiffs, Standard Poodles, Labrador Retrievers, Golden Retrievers, Doberman Pinschers and Chow Chows, according to various studies.

The real problem is “We don’t know what gets it started,” Nordone says, “what makes it turn into GDV. There have been few research efforts that have tried to define the mechanism underlying bloat.”

One common association with bloat is stress. This can be due to a “stressful event, such as boarding,” or just the fact that a particular dog is more nervous than the average dog, Nordone says. “That’s one of our special topics of interest – the elucidation of the neural pathology of GDV and improved understanding of how psycho-stressors” may play a role. “There’s a lot of interplay between the nervous system and the gastrointestinal system,” she says.

The request for research proposals details some topics of interest to the Bloat Initiative, such as “genetic risk variants,” explanations of “pathophysiological mechanisms,” “characterization of pathways mediating gastrointestinal motility [spontaneous movement] changes associated with GDV,” and explanations of “the neural pathology of GDV and improved understanding of how psychosocial stressors precipitate GDV” and of “whether environmental factors anecdotally associated with bloat [such as heat and humidity] are associated with aberrant physiological responses in high risk breeds.”

Researchers who have “hypotheses as to why some dogs bloat and others don’t,” as well as those who would take a genome-wide look at the canine for answers are expected to apply for grants, according to Nordone. What leads to GDV is “not going to be a single [gene] mutation,” she says.

Nordone says the committee deciding who will get research grants will take particular interest in proposals that include collaborative efforts. Neurologists, gastroenterologists and microbiologists are some of the research professionals who can “pool their expertise to help solve the problem. When you get people together with a broad range of experience, you really get synergy,” she says.

The foundation has “cast a wide net,” she says, to “see what comes of it.

“Hopefully if we can start to understand the mechanism of how and when bloat starts, we can start treating it before it gets into torsion,” the twisting that keeps air and fluid from leaving the stomach.

Regarding the first commitments for $250,000 worth of research and education, Nordone says, “It’s enough to get it started. For veterinary medicine, $250,000 awards are large. We’re hoping to make at least two to three $250,000 awards. In two to three years, we’ll have a much better idea of at least some of the mechanisms underlying GDV.”

Even over the telephone, Nordone’s feelings for this project come through loud and clear. “I’m excited because I think we can really put some evidence under why we see stress or gut motility associated with bloat. I’m excited about our donor excitement. The breed clubs and individual owners are very enthusiastic about us trying to do something about this. I think it’s going to be great.”

Donating toward the Bloat Initiative thus far are the Collie Health Foundation, Greyhound Club of America and the Irish Setter Club of America Foundation at $50,000-plus each; the Basset Hound Club of America and German Shepherd Dog Club of America at $25,000 to $24,999; the American Black & Tan Coonhound Club, American German Shepherd Dog Charitable Foundation, Briard Club of America Health and Education Trust, Gordon Setter Club of America, Greater Swiss Mountain Dog Club of America and Weimaraner Club of America at $10,000 to $24,999; and the American Bloodhound Club, English Springer Spaniel Field Trial Association, English Springer Spaniel Field Trial Association Foundation, Flat-Coated Retriever Foundation, Kuvasz Fanciers of America, TarTan Gordon Setter Club and Versatility in Poodles at $2,500 to $9,999.

Another part of the CHF Bloat Initiative is education for dog owners and veterinarians. Rozanski will give a webinar for owners in mid-2013. (We’ll be sure to let our readers know when the webinar is posted on the CHF website.) The webinar will include what’s already known about possible causes, susceptible breeds, symptoms, medical intervention and an explanation of research needed. “Because bloat progresses so rapidly, part of our focus is on educating the public on the signs and symptoms to look for if they suspect their dog may have bloat,” Nordone says. The foundation will also provide continuing education for veterinarians showing surgical procedures that can be used for prevention during spay and neuter surgeries.

Nordone says CHF “loves hearing from dog owners” and “getting feedback on what we’re doing and why we’re doing it.” She encourages Best In Show Daily readers to contact CHF and to go to the foundation’s Facebook page.

Susan Chaney has been on the editorial side of publishing since 1990, starting her career as a newspaper features writer and editor. A lifelong lover of dogs, Susan has lived with German Shepherds, Labs, Yorkies, an Irish Setter, a Great Dane-Bloodhound mix, a Sheltie and currently a Chihuahua mix of unknown pedigree. She was the editor of Dog Fancy magazine, content editor of DogChannel.com and group editor of Dog World, Dogs USA, Puppies USA, Natural Dog, Cat Fancy, Cats USA and Kittens USA from March 2005 to December 2009 when she left her position to work at home, part-time. Susan lives in Long Beach, Calif., with her artist husband, Tim, that Chi mix and two big cats. As an editor and writer for Best In Show Daily, she is reveling in the amalgam of three loves: writing, editing and dogs.

Susan, thanks for the update on GDV. Having owned Bloodhounds for 23 years and previously participated in the Purdue University Bloat Study, I am always interested in the current thoughts on the subject. Bloat has been studied for some time and no cause has been defined. We have done it all, wet food, dry food, no exercise, exercise, raised bowl, no raised bowl. We now gastroplexy all our Bloodhounds to eliminate the chance the torsion and feed a raw diet. This has been successful for our hounds. I am so pleased that the CHF is pursuing this issue. Thanks for the article!

Hi, Karen, I, too, am pleased that the CHF is pursuing this topic. It would be wonderful to finally know what causes this tragic condition. Interesting that you’ve found a raw diet helpful. Thanks for reading Best In Show Daily! Susan

The Collie Health Foundation (“CHF”) is very proud to sponsor of the AKCCHF Bloat Initiative towards understanding the cause of GDV and the possible prevention of this devasting condition and assist in leading the way towards education of veterinarians and owners.

Hi, Gerrie, It was amazing to see the list of breed clubs and foundations that are supporting this research. I was pretty astounded by the amount of the donations. It seems that it will “take a village” to get to the bottom of bloat. Congratulations to the Collie Health Foundation on its participation. Susan

As a long time Standard Poodle fancier, I am thrilled to hear about this study. I hope that PCA will also contribute. I would love to know anything that the public can do to help, whether it is submit information about our dogs that have bloated, or even do fundraising to contribute so that more money can be allocated for this research. So many lives of our beloved canine companions could be saved if the real causes of bloat could be known and eliminated!

Hi, Melanie, It certainly wouldn’t hurt for you to contact the PCA president about contributing. And anyone can make a donation directly to AKC CHF earmarked for the Bloat Initiative. Maybe you could host a fundraiser for your Poodle friends to attend? If we find out about any funded research that needs subjects in private homes, we’ll let you and all of our readers know. Thanks for commenting, Melanie. Susan

I am so glad to see this study! My four year old Lab has battled bloat since he was 5/6 months old. I, too, have tried a plethora of remedies to make his life easier and to keep him well…kibble, no kibble, add water-don’t add water, exercise-no exercise, raised dish-no raised dish, cold laser therapy, pro-biotics, etc………the list is long. We continue to battle today…but we keep the faith this study will provide valid answers.

As Presidente of Colombian Breeders Association (Colombia, South America), I want to thank you because this update about GDV. We are very interested in teaching our breeders in order to get the best for their breeds. I want to ask you about genetic issue in this field. We know there are “lines” that have more GDV and for this reason we try to stay away of them. Thanks again.

Thanks for writing, Camilo. It is very likely that the genetic aspect will be one of the pieces of research that the CHF will fund. I’ll be reporting on the funding awards in the fall when they’re decided.

Has there been any thought to the ratio of depth of chest to width of chest? A long time Newfoundland breeder once told me she observed that the dogs she knew who bloated, were narrower and deeper chested than most. Newfoundlands also have this problem.

The CHF Chief Scientific Officer sent me quite a bit of the more recent research on this topic. I don’t remember seeing this ration among the associations studied. I’ll check with her, though. Thank you for commenting!

This is such a horrible disease. Years ago my dobie bloated first time and vet tacked the tummy. Several months later he bloated on an EMPTY stomach which I didn’t even know was possible! I had switched him to raw and he stayed on that for over a year, elevated food bowl, etc. He survived and lived until he was 12+, but I would have given anything to know what caused this. Thank you for the update.